Symptoms

Increased pain and stiffness in the morning and after inactivity that lasts more than 30 minutes

Red, swollen, warm joints

Deformed, misshapen joints

RA may also cause:

Intense fatigue, decreased energy

Muscle aches

Decreased appetite

Weight loss

Fever and sweats

Insomnia

Small lumps or nodules under the skin

Inflammation may also occur in

Eyes

Mouth

Skin

Lungs

Blood and blood vessels

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. RA is sometimes difficult to diagnose because there are several diseases with similar symptoms. Part of diagnosing RA is to rule out other diseases.

The American College of Rheumatology and the European League Against Rheumatism have created a system for diagnosing RA. To start, symptoms need to be present for 6 weeks or more. The system then uses a 10-point scale assessing specific symptoms. The higher the score, the more likely RA is present. Considered factors include:

The number of swollen or sore joints with any associated damage. This includes both small and large joints. Which joints are affected, how many joints are affected, and for how long they have been affected all help with the diagnosis.

Blood tests that look for markers of RA. Specific substances, such as those associated with autoimmunity and inflammation, may be present in the blood.

Imaging tests to look at the affected joint and surrounding structures. These may include:

Synovial biopsy—Removing a piece of the synovial membrane that lines the joint capsule.

Arthrocentesis (joint aspiration)—Removal of synovial fluid from the joint with a needle.

Treatment

There is no cure for RA. The goals of treatment are to:

Relieve pain

Reduce inflammation

Slow down joint damage

Improve functional ability

Medications

There are a variety of medications to treat the pain and inflammation of RA. In some cases, medications may be used in combination. These may include:

Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, cyclooxgenase-2, or COX-2 inhibitors. They may be applied to the skin or taken by mouth.

Disease-modifying antirheumatic drugs (DMARDs) are injected under the skin or taken by mouth. DMARDs include:

Nonbiologics suppress the immune system. The most common is nonbiologic DMARD is methotrexate.

Biologics attempt to repair, stimulate, or enhance the immune system. Common biologic DMARDs include adalimumab, etanercept, and abatacept.

Corticosteroids—injected into the joint (less common)

Rest and Exercise

Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility. It also preserves joint mobility.

These steps may help relieve stiffness, weakness, and reduce inflammation:

Maintain a balance between rest and exercise

Attempt mild strength training

Participate in aerobic exercise, such as, walking, swimming, or dancing

Avoid heavy-impact exercise

Control weight

Participate in a physical therapy program

Joint Care

Splints applied to painful joints may reduce pain. Devices that help with daily activities can also reduce stress on joints. Devices include:

Zipper extenders

Long-handled shoehorns

Specially designed kitchen tools

Stress Reduction

Stress reduction
can ease the difficulties of living with a chronic, painful disease. Participating in an exercise program or joining a
support group
are 2 strategies you can use to reduce stress.
Cognitive behavioral therapy
, a form of talk therapy, and
meditation
may also offer benefits in reducing your pain and improving your ability to cope with RA.

Prevention

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.